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ENT 1 > PHARM- SAR & perennial rhinitis > Flashcards

PHARM- SAR & perennial rhinitis Flashcards

1
Q

MOA of 1st gen antihistamines

A

competes w/ histamine on H1 receptor sites of blood vessels & resp tract

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2
Q

drowsiness, cognitive impairment & anticholinergic effects

A

ADR of 1st gen antihistamines

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3
Q

how can a pt minimize ADR of 1st gen antihistamines

A

using it more; usually taken QHS

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4
Q

which is better for congestion– 1st or 2nd gen antihistamines?

A

1st gen but still not great for congestion

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5
Q

name the two 1st gen antihistamines

A

diphenhydramine
chlorpheniramine

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6
Q

are 1st gen antihistamine safe in pregnancy? how about kids?

A

both are safe in pregnacy
diphenhydramine is for over 3yo, chlor is for over 2 yo

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7
Q

indications of nasal corticosteroids

A

once-daily tx of non-infectious rhinitis
tx & prevention of nasal polyps

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8
Q

compare efficacy of antihistamines & nasal steroids for allergic rhinitis

A

steroids are highly efficacious for it, more effective than mono-therapy with antihistamines

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9
Q

4 major sx of allergic rhinitis that is controlled w/ nasal steroids

A

sneezing
itching
rhinorrhea
congestion

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10
Q

does nasal steroid work well for ocular sx?

A

not really

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11
Q

two possible side effects of nasal steroids

A

nasal dryness
epistaxis

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12
Q

how should you use nasal steroids? PRN or daily?

A

daily but there is tolerance with prolonged use

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13
Q

name your 3 nasal steroid

A

mometasone (nasonex)
fluticasone (flonase)
budesonide (rhinocort aqua)

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14
Q

which of the nasal steroids have no mineralocorticoid/androgenic effect?

A

mometasone

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15
Q

which nasal steroid reduces intraepithelial eosinophilia & inflammatory cell infiltration?

A

mometasone

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16
Q

of puff limit with fluticasone

A

4 puffs/day
for >4 yo

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17
Q

which nasal steroid has water to decrease the drying and irritating effect and is better tolerated

A

budesonide

18
Q

2nd gen antihistamine MOA

A

same as 1st gen but also works in GI tract

19
Q

how does 2nd gen ADR compare w/ 1st gen

A

2nd gen has less sedation and anticholinergic effects

20
Q

which class of meds reduce hypersensitivity rxn

A

2nd gen antihistamine

21
Q

indication for 2nd gen antihistamines

A

allergic rhinitis (but not nasal congestion)
occupational rhinitis

22
Q

name the 3 second-gen antihistamines

A

cetirizine (zyrtec)
fexofenadine (allegra)
loratadine (claritin)

23
Q

only mediation for rhinitis that is okay in kids less than 2 years old

A

cetirizine (zyrtec)– ok in over 6 months old

24
Q

which medication is the most sedating of the 2nd gen antihistamines & has the most SE

A

certirizine (zyrtec)

25
Q

2nd gen antihistamine age requirements

A

certirizine (zyrtec): >6 months; >6 yo for adult dose
fexofenadine (allegra): >6yo; >12 yo for adult dose
loratadine (claritin): >2 yo; >5 yo for adult dose

26
Q

onset & duration of antihistamine nasal sprays

A

15 min onset
up to 4hrs

27
Q

ADR of bitter taste, HA, epistaxis, sedation, irritation

A

antihistamine nasal spray

28
Q

why are nasal antihistamines 2nd line (3 reasons)

A

cost
ADR
less effective compared to nasal steroids

29
Q

name the two nasal antihistamines

A

azelastine
olopatadine

30
Q

are nasal antihistamines safe in pregnacy?

A

they are category C

31
Q

age requirements with nasal antihistamines

A

azelastine: 5+
olopatadine 6+

32
Q

how do anticholinergic nasal sprays work?

A

they inhibit nasal mucous gland secretions
great for excessive rhinorrhea

33
Q

mucosal dryness, epistaxis, HA

A

ADR of anticholinergics

34
Q

2 indicators for anticholinergic nasal sprays

A

vasomotor rhinitis
gustatory rhinitis
resolves sx of excessive rhinorrhea ONLY!

35
Q

pregnancy safety and age requirement for anticholinergic nasal sprays

A

preg cat B
6+ yo

36
Q

name the single anticholinergic nasal spray

A

Ipratropium

37
Q

which two classes are effective for nasal congestion

A

intranasal antihistamine
intranasal corticosteroid

38
Q

all of these 3 sx are covered by all classes except anticholinergics

A

itching
sneezing
rhinorrhea

39
Q

name the two leukotriene receptor antagonists

A

montelukast (singulair)
zafirlukast (accolate)

40
Q

leukotriene antagonist MOA

A

prevents release of leukotrienes from mast cells & eosinophils

41
Q

leukotriene antagonist/Montelukast indications

A

seasonal & perennial rhinitis
long-term asthma control
exercised induced bronchospasms

42
Q

ADR of URI, fever, HA, pharyngitis, cough, abdominal pain, neuropsychiatric/suicidality

A

montelukast

ENT 1 (9 decks)

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